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General NPI Number Information
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NPI Number | 1265233019
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Entity Type | Organization
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Legal Business Name | NOVASPINE PAIN INSTITUTE, PLC
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 14300 W GRANITE VALLEY DR STE A1
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-5797
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Country | US
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Telephone | 623-777-4747
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Fax | 623-777-4748
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Provider Business Mailing Address
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Address Line | 14300 W GRANITE VALLEY DR STE A1
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-5797
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Country | US
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Telephone | 623-777-4747
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Fax | 623-777-4748
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Authorized Official
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Title or Position | OWNER
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Name | CLIFFORD TSUYOSHI BAKER
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Credential | MD
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Telephone | 623-777-4747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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